The upper cut: Teen pregnancy prevention

Clinical Brief – August 29th

The Brief

In July 2017, the DHHS in the US announced funding cuts and an end to its Teen Pregnancy Prevention Program.

In a commentary, the potential consequences of these cuts are laid bare: Lowering the age of first intercourse, increasing the rate of premarital sex among teens, increasing the number of unintended pregnancies, and increasing the number of abortions.

What’s the deal?

In a commentary in the journal JAMA Internal Medicine, Prof Charo warned that these cuts are “likely to reverse what has been a successful trend in public health and adolescent well-being”.

Interventions in the Teen Pregnancy Prevention Program have helped adolescents avoid unprotected sex, reduce the rate of unprotected sex among vulnerable minorities, and delay the age of first intercourse.

Sex, but later.

Delaying the age of first intercourse is important, according to Prof Charo.

“Sexually active teens 17 years or younger have lower rates of contraceptive use than older teens, and failure to use contraception quintuples their risk of pregnancy, compared with older teens who use some form of protection.”

– Charo RA

What the US stands to lose.

Stats by the CDC has shown that nearly half of all teens are sexually experienced today and in 2002, but the rate of contraception among teens has risen from ~73% to 80%.

In 2016, ~210k birth to teenagers in the US was reported, which is less than half the number reported back in 2007. There is also data that shows declines in pregnancy is tied to declines in abortions.

“These temporal trends coincide with, among other factors, the shift in policy under the Obama Administration…Despite these obvious successes, the Trump Administration has shown a consistent hostility to family planning and women’s health.”

– Charo RA

Prof Charo closes by reiterating that public health should be about what works. She points out that neither parental nor religious guidance alone works to reduce teen pregnancies. Comprehensive sex education that emphasizes both abstinence and contraception does.

One last quote

“For the sake of our children, and their future children, we should build on the progress that has been made, not go backward.”

– Charo RA

About Prof Charo

R. Alta Charo is the Warren P. Knowles Professor of Law and Bioethics at the University of Wisconsin at Madison.

Prof Charo served on President Obama’s transition team, where she was a member of the HHS review team, focusing her attention particularly on transition issues related to NIH, FDA, bioethics, stem cell policy, and women’s reproductive health.

She was on leave 2009-2011 to serve as a senior policy advisor on emerging technology issues in the Office of the Commissioner at the US FDA.

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